Dissimilar Modes Of Action Research Articles

The zebrafish embryo as a model for chemically-induced steatosis: A case study with three pesticides

There is an increasing incidence and prevalence of fatty liver disease in the western world, with steatosis as the most prevalent variant. Known causes of steatosis include exposure to food-borne chemicals, and overconsumption of alcohol, carbohydrates and fat, and it is a well-known side effect of certain pharmaceuticals such as tetracycline, amiodarone and tamoxifen (drug-induced hepatic steatosis). Mechanistic knowledge on chemical-induced steatosis has greatly evolved and has been organized into adverse outcome pathways (AOPs) describing the chain of events from first molecular interaction of a substance with a biological system to the adverse outcome, intrahepatic lipid accumulation. In this study, three known steatosis-inducing pesticides (imazalil, clothianidin, and thiacloprid) were tested for their ability to induce hepatic triglyceride accumulation in the zebrafish (Danio rerio) embryo (ZFE) at 5 days post fertilization, both as single compounds and equipotent binary mixtures. The results indicate that the ZFE is very well applicable as a higher tier testing model to confirm effects in downstream key events in AOPs, that is, chemically-induced triglyceride accumulation in the whole organism and production of visible steatosis. Moreover, dose addition could be concluded for binary mixtures of substances with similar and with dissimilar modes of action.

Bifunctional antibiotic hybrids: A review of clinical candidates.

Antibiotic resistance is a top threat to human health and a priority across the globe. This problematic issue is accompanied by the decline of new antibiotics in the pipeline over the past 30years. In this context, an urgent need to develop new strategies to combat antimicrobial resistance is in great demand. Lately, among the possible approaches used to deal with antimicrobial resistance is the covalent ligation of two antibiotic pharmacophores that target the bacterial cells through a dissimilar mode of action into a single hybrid molecule, namely hybrid antibiotics. This strategy exhibits several advantages, including better antibacterial activity, overcoming the existing resistance towards individual antibiotics, and may ultimately delay the onset of bacterial resistance. This review sheds light on the latest development of the dual antibiotic hybrids pipeline, their potential mechanisms of action, and challenges in their use.

Dose Addition in the Induction of Craniofacial Malformations in Zebrafish Embryos Exposed to a Complex Mixture of Food-Relevant Chemicals with Dissimilar Modes of Action.

Background:Humans are exposed to combinations of chemicals. In cumulative risk assessment (CRA), regulatory bodies such as the European Food Safety Authority consider dose addition as a default and sufficiently conservative approach. The principle of dose addition was confirmed previously for inducing craniofacial malformations in zebrafish embryos in binary mixtures of chemicals with either similar or dissimilar modes of action (MOAs).Objectives:In this study, we explored a workflow to select and experimentally test multiple compounds as a complex mixture with each of the compounds at or below its no observed adverse effect level (NOAEL), in the same zebrafish embryo model.Methods:Selection of candidate compounds that potentially induce craniofacial malformations was done using in silico methods—structural similarity, molecular docking, and quantitative structure–activity relationships—applied to a database of chemicals relevant for oral exposure in humans via food (EuroMix inventory, ). A final subselection was made manually to represent different regulatory fields (e.g., food additives, industrial chemicals, plant protection products), different chemical families, and different MOAs.Results:A final selection of eight compounds was examined in the zebrafish embryo model, and craniofacial malformations were observed in embryos exposed to each of the compounds, thus confirming the developmental toxicity as predicted by the in silico methods. When exposed to a mixture of the eight compounds, each at its NOAEL, substantial craniofacial malformations were observed; according to a dose–response analysis, even embryos exposed to a 7-fold dilution of this mixture still exhibited a slight abnormal phenotype. The cumulative effect of the compounds in the mixture was in accordance with dose addition (added doses of the individual compounds after adjustment for relative potencies), despite different MOAs of the compounds involved.Discussion:This case study of a complex mixture inducing craniofacial malformations in zebrafish embryos shows that dose addition can adequately predicted the cumulative effect of a mixture of multiple substances at low doses, irrespective of the (expected) MOA. The applied workflow may be useful as an approach for CRA in general. https://doi.org/10.1289/EHP9888

Moving toward the Real World: Zebrafish Transcript Map Predicts Mixture Effects Using Single-Compound Data.

Moving toward the Real World: Zebrafish Transcript Map Predicts Mixture Effects Using Single-Compound Data.

Combining in vitro assays and mathematical modelling to study developmental neurotoxicity induced by chemical mixtures

Prenatal and postnatal co-exposure to multiple chemicals at the same time may have deleterious effects on the developing nervous system. We previously showed that chemicals acting through similar mode of action (MoA) and grouped based on perturbation of brain derived neurotrophic factor (BDNF), induced greater neurotoxic effects on human induced pluripotent stem cell (hiPSC)-derived neurons and astrocytes compared to chemicals with dissimilar MoA. Here we assessed the effects of repeated dose (14 days) treatments with mixtures containing the six chemicals tested in our previous study (Bisphenol A, Chlorpyrifos, Lead(II) chloride, Methylmercury chloride, PCB138 and Valproic acid) along with 2,2′4,4′-tetrabromodiphenyl ether (BDE47), Ethanol, Vinclozolin and 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)), on hiPSC-derived neural stem cells undergoing differentiation toward mixed neurons/astrocytes up to 21 days. Similar MoA chemicals in mixtures caused an increase of BDNF levels and neurite outgrowth, and a decrease of synapse formation, which led to inhibition of electrical activity. Perturbations of these endpoints are described as common key events in adverse outcome pathways (AOPs) specific for DNT. When compared with mixtures tested in our previous study, adding similarly acting chemicals (BDE47 and EtOH) to the mixture resulted in a stronger downregulation of synapses. A synergistic effect on some synaptogenesis-related features (PSD95 in particular) was hypothesized upon treatment with tested mixtures, as indicated by mathematical modelling. Our findings confirm that the use of human iPSC-derived mixed neuronal/glial models applied to a battery of in vitro assays anchored to key events in DNT AOP networks, combined with mathematical modelling, is a suitable testing strategy to assess in vitro DNT induced by chemical mixtures.

Defining embryonic developmental effects of chemical mixtures using the embryonic stem cell test

The embryonic stem cell test (EST) was applied to evaluate dose addition in combined exposures of teratogenic compounds in the EFSA-defined cumulative assessment group “craniofacial malformations”, which was one of the selected cases in the EU-H2020 project “EuroMix”. Test compounds were selected through reported effects in rodents, and represented a wide variety of chemical families and modes of action (MOA), including triazoles to inhibit CYP26; (synthetic) retinoids, to activate RAR/RXR; valproic acid, to inhibit histone deacetylase; dithiocarbamates, to disrupt extracellular matrix formation; dioxin (-like) compounds, to activate the aryl hydrocarbon receptor; 17alpha-ethynylestradiol, to activate the estrogen receptor; 5-fluorouracil, to disrupt DNA-synthesis; MEHP and PFOS, to activate peroxisome proliferation activated receptors; and methyl mercury, to induce oxidative stress and inhibit protein function. The EST appeared particularly useful to evaluate differentiation-inhibiting effects of compounds targeting early processes in craniofacial development, possibly related to the early fate of neural crest cells. Mixtures, designed as equipotent concentrations of two compounds with similar or dissimilar MOA, and single compounds showed overlapping dose-responses. This observation is consistent with dose addition in the EST in all studied binary mixtures, irrespective of MOA, and thereby supports the application of dose-addition as a default in cumulative risk assessment.

House fly resistance to chlorantraniliprole: cross resistance patterns, stability and associated fitness costs.

The house fly, Musca domestica L. (Diptera: Muscidae) is an important public health pest that serves as a carrier for pathogens transmitting various diseases of man and animals. It is well known for rapid resistance development to insecticides applied for its chemical control. Chlorantraniliprole, an anthranilic diamide, a ryanodine receptor agonist, is a promising agent for the integrated pest management of various insect pests. To design a retrospective resistance management strategy, life history traits of the chlorantraniliprole laboratory-selected (CTPR-SEL) and unselected counterpart (UNSEL) sub-populations of a field strain and their reciprocal crosses were studied. After eight generations of consecutive selection with chlorantraniliprole, a 750-fold resistance level when compared to a susceptible strain and a 124-fold resistance level when compared to the UNSEL strain had developed in CTPR-SEL. Very low cross resistance to bifenthrin but no cross resistance to spinosad and fipronil was observed in the CTPR-SEL strain. Results of the fitness traits suggest that the CTPR-SEL has a lower relative fitness (0.34), reduced fecundity, a decrease in eggs hatchability, lower biotic potential and net reproductive rate as compared to the UNSEL strain. Interestingly, chlorantraniliprole resistance was unstable in the CTPR-SEL. Fitness costs associated with chlorantraniliprole resistance suggest that the efficacy of this insecticide could be preserved for a prolonged duration of time by alternating its use with insecticides having dissimilar modes of action and no cross resistance. When cross-resistance is absent, a sequence of two insecticides is expected to be more durable than a mixture unless the population's h2 of resistance to the mixture is less than half of the mean of the population's h2 of resistance to the two individual components of the mixture. Unstable chlorantraniliprole resistance could also help to sustain its efficacy by being withdrawn from usage for some period of time. © 2019 Society of Chemical Industry.

Enriching cancer pharmacology with drugs of marine origin.

Marine natural products have proven, over the last half-century, to be effective biological modulators. These molecules have revealed new targets for cancer therapy as well as dissimilar modes of action within typical classes of drugs. In this scenario, innovation from marine-based pharmaceuticals has helped advance cancer chemotherapy in many aspects, as most of these are designated as first-in-class drugs. Here, by examining the path from discovery to development of clinically approved drugs of marine origin for cancer treatment-cytarabine (Cytosar-U®), trabectedin (Yondelis®), eribulin (Halaven®), brentuximab vedotin (Adcetris®), and plitidepsin (Aplidin®)- together with those in late clinical trial phases-lurbinectedin, plinabulin, marizomib, and plocabulin-the present review offers a critical analysis of the contributions given by these new compounds to cancer pharmacotherapy.

Sublethal metabolic responses to contaminant mixture toxicity in Daphnia magna.

Anthropogenic activity is increasing the presence of contaminants that enter waterways through wastewater effluent and urban and/or agricultural runoff, generally in complex mixtures. Depending on the mode of action of the individual contaminant within the mixture, toxicity can occur due to contaminants having similar or dissimilar modes of action. However, it is unknown how the metabolome responds to sublethal contaminant mixtures in the keystone genus Daphnia. In the present study we examined D. magna metabolic responses to acute sublethal exposure of propranolol, carbamazepine, and perfluorooctanesulfonic acid (PFOS) as well as in binary (propranolol-carbamazepine, propranolol-PFOS, carbamazepine-PFOS) and tertiary mixtures (carbamazepine-propranolol-PFOS), all at 10% of the median lethal concentration of the population (LC50). The metabolome was measured using 1 H nuclear magnetic resonance (NMR) and characterized using principal component analysis, regression analysis, and fold changes in metabolite relative to the unexposed (control) group. The averaged principal component analysis scores plots revealed that carbamazepine-PFOS and carbamazepine-propranolol-PFOS exposures were significantly different from the control treatment. After normalizing the toxicity of each contaminant, we found that some metabolites responded monotonically, whereas others displayed a nonmonotonic response with increasing toxicity units. The single contaminant exposures and 2 binary mixtures (propranolol-carbamazepine, and propranolol-PFOS) resulted in minimal changes in the identified metabolites, whereas the carbamazepine-PFOS and carbamazepine-propranolol-PFOS displayed increases in several amino acid metabolites and decreases in glucose. Overall, our results highlight the sensitivity of the metabolome to distinguish the composition of the contaminant mixtures, with some mixtures displaying heightened responses versus others. Environ Toxicol Chem 2018;37:2448-2457. © 2018 SETAC.

Mixture toxicity of five biocides with dissimilar modes of action on the growth and photosystem II efficiency of Chlamydomonas reinhardtii

ABSTRACTBiocides are extensively used and universally distributed. Some are highly toxic to algae, including antifoulants, herbicides, and fungicides. The inhibition of algal growth is an important regulatory endpoint for toxicity assessment of single compounds. However, in the aquatic environment, mixtures of compounds with unknown toxicities and mode of action (MoA) co-exist, making single toxicity assessment inadequate to ensure protection of the aquatic environment. This study aimed to characterize the combined toxicity of five environmentally relevant biocides—aclonifen, bifenox, dichlofluanid, metribuzin, and triclosan—with different MoA on growth and photosystem (PS) II efficiency of Chlamydomonas reinhardtii. For growth inhibition, herbicides bifenox and metribuzin were the most toxic, whereas triclosan was least. Only aclonifen and metribuzin exerted a significant effect on PSII, which was also correlated with reduced algal growth. The combined effect of the five biocides on growth inhibition was predominantly additive and presumed to act by independent MoA with potential antagonism observed only at low concentrations and at shorter duration of exposure. The binary mixture of metribuzin and aclonifen exhibited additive effects on diminished PSII efficiency, and effects were apparently induced by an independent MoA. Potential synergy of this mixture on growth inhibition was identified at the highest concentrations. Growth inhibition was found to be a more valuable endpoint for regulatory studies than PSII inhibition due to its environmental relevance, integration of multiple MoA and sensitivity.

Predicting herbicide mixture effects on multiple algal species using mixture toxicity models.

The validity of the application of mixture toxicity models, concentration addition and independent action, to a species sensitivity distribution (SSD) for calculation of a multisubstance potentially affected fraction was examined in laboratory experiments. Toxicity assays of herbicide mixtures using 5 species of periphytic algae were conducted. Two mixture experiments were designed: a mixture of 5 herbicides with similar modes of action and a mixture of 5 herbicides with dissimilar modes of action, corresponding to the assumptions of the concentration addition and independent action models, respectively. Experimentally obtained mixture effects on 5 algal species were converted to the fraction of affected (>50% effect on growth rate) species. The predictive ability of the concentration addition and independent action models with direct application to SSD depended on the mode of action of chemicals. That is, prediction was better for the concentration addition model than the independent action model for the mixture of herbicides with similar modes of action. In contrast, prediction was better for the independent action model than the concentration addition model for the mixture of herbicides with dissimilar modes of action. Thus, the concentration addition and independent action models could be applied to SSD in the same manner as for a single-species effect. The present study to validate the application of the concentration addition and independent action models to SSD supports the usefulness of the multisubstance potentially affected fraction as the index of ecological risk. Environ Toxicol Chem 2017;36:2624-2630. © 2017 SETAC.

Comparative proteomic analysis of 2-MCPD- and 3-MCPD-induced heart toxicity in the rat.

The chlorinated propanols 2- and 3-monochloropropanediol (MCPD), and their fatty acid esters have gained public attention due to their frequent occurrence as heat-induced food contaminants. Toxic properties of 3-MCPD in kidney and testis have extensively been characterized. Other 3-MCPD target organs include heart and liver, while 2-MCPD toxicity has been observed in striated muscle, heart, kidney, and liver. Inhibition of glycolysis appears to be important in 3-MCPD toxicity, whereas mechanisms of 2-MCPD toxicity are still unknown. It is thus not clear whether toxicity by the two isomeric compounds is dependent on similar or dissimilar modes of action. A 28-day oral feeding study in rats was conducted using daily non-toxic doses of 2-MCPD or 3-MCPD [10mg/kg body weight], or an equimolar (53mg/kg body weight) or a lower (13.3mg/kg body weight) dose of 2-MCPD dipalmitate. Comprehensive comparative proteomic analyses of substance-induced alterations in the common target organ heart revealed striking similarities between effects induced by 2-MCPD and its dipalmitate ester, whereas the degree of effect overlap between 2-MCPD and 3-MCPD was much less. The present data demonstrate that even if exerting effects in the same organ and targeting similar metabolic networks, profound differences between molecular effects of 2-MCPD and 3-MCPD exist thus warranting the necessity of separate risk assessment for the two substances. This study for the first time provides molecular insight into molecular details of 2-MCPD toxicity. Furthermore, for the first time, molecular data on 3-MCPD toxicity in the heart are presented.

Additive toxicity of zinc and arsenate on barley (Hordeum vulgare) root elongation.

Zinc (Zn) and arsenic (As) are typically present as mixed contaminants in mining-impacted areas; however, their joined effects have rarely been evaluated. The present study was set up to test whether the Zn2+ and H2 AsO4- (hereafter, As) mixture toxicity to plants is additive or whether interactions occur. Barley (Hordeum vulgare) root elongation was measured in resin buffered nutrient solutions. The design included ranges of single-element concentrations and combinations at 3 different Ca2+ concentrations (0.5 mM, 2.2 mM, and 15.0 mM) to vary the relative toxicity of Zn2+ . Increasing Ca concentrations decreased Zn toxicity, whereas As toxicity was unaffected by Ca. Root elongation was generally more affected in Zn-As mixtures than in corresponding single-element treatments. This is merely a joint additive effect, as 96% of the root elongation data were within a factor of 1.2 from predictions using the independent action (IA) or concentration addition (CA) model. The CA and IA predictions were similar, and data did not allow identification of equal or dissimilar modes of action. Small but significant Zn-As antagonisms were only found at high effects (>50% inhibition). The present study suggests that mixture effects of Zn and As are environmentally relevant and that current risk assessment underestimates toxicity in multielement-contaminated environments. The CA model can be used as a conservative model for risk assessment; however, for soil-grown plants, soil-exposed studies are needed. Environ Toxicol Chem 2017;36:1556-1562. © 2016 SETAC.

Combined toxic effect of airborne heavy metals on human lung cell line A549.

Many studies have demonstrated that heavy metals existing as a mixture in the atmospheric environment cause adverse effects on human health and are important key factors of cytotoxicity; however, little investigation has been conducted on a toxicological study of a metal mixture from atmospheric fine particulate matter. The objective of this study was to predict the combined effects of heavy metals in aerosol by using in vitro human cells and obtain a suitable mixture toxicity model. Arsenic, nickel, and lead were selected for mixtures exposed to A549 human lung cancer cells. Cell proliferation (WST-1), glutathione (GSH), and interleukin (IL)-8 inhibition were observed and applied to the prediction models of mixture toxicity, concentration addition (CA) and independent action (IA). The total mixture concentrations were set by an IC10-fixed ratio of individual toxicity to be more realistic for mortality and enzyme inhibition tests. The results showed that the IA model was statistically closer to the observed results than the CA model in mortality, indicating dissimilar modes of action. For the GSH inhibition, the results predicted by the IA and CA models were highly overestimated relative to mortality. Meanwhile, the IL-8 results were stable with no significant change in immune reaction related to inflammation. In conclusion, the IA model is a rapid prediction model in heavy metals mixtures; mortality, as a total outcome of cell response, is a good tool for demonstrating the combined toxicity rather than other biochemical responses.

Characterization of the effects of binary metal mixtures on short-term uptake of Ag, Cu, and Ni by rainbow trout (Oncorhynchus mykiss)

Single metal Biotic Ligand Models (BLMs) have been developed for a number of metals and model organisms. While these BLMs improve our ability to regulate metals in the aquatic environment, in reality, organisms are often simultaneously exposed to metal mixtures. Recently, several attempts have been made to develop mixture BLMs (mBLMs). Some of these models assume competitive interactions between all metals, while others assume only metals with a similar mode of action (e.g., Na+ or Ca2+ antagonists) will competitively interact. To begin testing these assumptions in the mBLM framework, standard 3-h gill metal binding assays with Ag, Cu, and Ni (primary metals), were performed in vivo on freshwater rainbow trout. Fish were exposed across a range of concentrations encompassing the 96-h LC50 for that metal to characterize uptake kinetics for each of these three primary metals (radiolabelled) in the presence and absence of a secondary metal (Ag, Cd, Cu, Ni, Pb, or Zn; not radiolabelled). We observed a complex series of interactions in binary mixtures that frequently contradicted theoretical expectations. Metals with similar modes of action did competitively interact in some instances, but not others, and when they did compete the competition was not necessarily reciprocal (e.g., Cu inhibited Ag uptake but Ag did not inhibit Cu uptake). We also observed examples of interactions between metals with dissimilar modes of action and several examples of metals stimulating the uptake of other metals. The underlying mechanisms for these unexpected interactions are unclear, but suggest that many of the current assumptions in mBLMs regarding the number and types of metal uptake sites and corresponding metal interactions are not correct. Careful characterization of metal mixture interactions is clearly needed before a reliable mBLM can be developed.

From Solution to Biointerface: Graphene Self-Assemblies of Varying Lateral Sizes and Surface Properties for Biofilm Control and Osteodifferentiation.

Bringing multifunctional graphene out of solution through facile self-assembly to form 2D surface nanostructures, with control over the lateral size and surface properties, would be an intriguing accomplishment, especially in biomedical fields where biointerfaces with functional diversity are in high demand. Guided by this goal, in this work, we built such graphene-based self-assemblies on orthopedic titanium, attempting to selectively regulate bacterial activities and osteoblastic functions, which are both crucial in bone regeneration. Briefly, large-area graphene oxide (GO) sheets and functionalized reduced GO (rGO) micro-/nanosheets were self-assembled spontaneously and controllably onto solid Ti, through an evaporation-assisted electrostatic assembly process and a mussel-inspired one-pot assembly process, respectively. The resultant layers were characterized in terms of topological structure, chemical composition, hydrophilicity, and protein adsorption properties. The antibacterial efficacies of the assemblies were examined by challenging them with pathogenic Staphylococcus aureus (S. aureus) bacteria that produce biofilms, whereby around 50% antiadhesion effects and considerable antibiofilm activities were observed for both layer types but through dissimilar modes of action. Their cytocompatibility and osteogenic potential were also investigated. Interfaced with MC3T3-E1 cells, the functionalized rGO sheets evoked better cell adhesion and growth than GO sheets, whereas the latter elicited higher osteodifferentiation activity throughout a 28-day in vitro culture. In this work, we showed that it is technically possible to construct graphene interface layers of varying lateral dimensions and surface properties and confirmed the concept of using the obtained assemblies to address the two major challenges facing orthopedic clinics. In addition, we determined fundamental implications for understanding the surface-biology relationship of graphene biomaterials, in efforts to better design and more safely use them for future biomedicine.

Investigation into the mechanism of action of the antimicrobial peptides Os and Os-C derived from a tick defensin

Os and Os-C are two novel antimicrobial peptides, derived from a tick defensin, which have been shown to have a larger range of antimicrobial activity than the parent peptide, OsDef2. The aim of this study was to determine whether the peptides Os and Os-C are mainly membrane acting, or if these peptides have possible additional intracellular targets in Escherichia coli and Bacillus subtilis. Transmission electron microscopy revealed that both peptides adversely affected intracellular structure of both bacteria causing different degrees of granulation of the intracellular contents. At the minimum bactericidal concentrations, permeabilization as determined with the SYTOX green assay seemed not to be the principle mode of killing when compared to melittin. However, fluorescent triple staining indicated that the peptides caused permeabilization of stationary phase bacteria and TEM indicated membrane effects. Studies using fluorescently labeled peptides revealed that the membrane penetrating activity of Os and Os-C was similar to buforin II. Os-C was found to associate with the septa of B. subtilis. Plasmid binding studies showed that Os and Os-C binds E. coli plasmid DNA at a similar charge ratio as melittin. These studies suggest membrane activity for Os and Os-C with possible intracellular targets such as DNA. The differences in permeabilization at lower concentrations and binding to DNA between Os and Os-C, suggest that the two peptides have dissimilar modes of action.

The relevance of combined action of chemicals through dissimilar modes of action. A science based approach for performing cumulative risk assessment of pesticides residues

The relevance of combined action of chemicals through dissimilar modes of action. A science based approach for performing cumulative risk assessment of pesticides residues

Implication of DEB theory in assessment of mixture toxicity of chemicals with dissimilar mode of action to Daphnia magna

Implication of DEB theory in assessment of mixture toxicity of chemicals with dissimilar mode of action to Daphnia magna

Scientific Opinion on the relevance of dissimilar mode of action and its appropriate application for cumulative risk assessment of pesticides residues in food

The European Food Safety Authority (EFSA) asked the Panel on Plant Protection Products and their Residues (PPR Panel) to develop a Scientific Opinion on the relevance of dissimilar mode of action and its appropriate application for cumulative risk assessment of pesticides residues in food. The present opinion was preceded by three previous opinions of the PPR Panel (EFSA, 2008, 2009, 2013). The purpose of the present opinion was to assess the relevance of dissimilar modes of action (MoA) for cumulative risk assessment, to evaluate the existing methods for assessing chemicals acting by dissimilar MoA and to identify which methods need to be considered. The PPR Panel restricted its considerations of pesticide combinations with dissimilar modes of action to substances that produce a common adverse effect on the same organ/system. The PPR Panel noted that there is no case documented in the scientific literature where independent action provided more conservative predictions of combination effects than dose addition, and where at the same time independent action also produced accurate predictions. The use of independent action as an assessment concept for combination effects requires demonstration that modes of action of individual substances in a mixture are strictly independent, a condition that can rarely be met in practice. The PPR Panel also noted that there is no cumulative risk assessment method derived from independent action. The PPR Panel therefore recommends using cumulative risk assessment methods derived from dose addition also for the assessment of mixtures of pesticides with dissimilar modes of action, provided they produce a common adverse outcome. Pesticides that produce common adverse outcomes on the same target organ/system should be grouped together in CAGs, and their combined effects assessed by using the concept of dose addition as a pragmatic and conservative default approach for the purpose of assessing cumulative risk in relation to MRL setting or risk assessment of chemical mixtures in practice.